Service Dogs: An Unconventional Medicine for Mental Health Issues

The Department of Justice set service dog guidelines under the 1990 Americans with Disability Act (ADA) and 1988 amendment to the Fair Housing Act of 1968. According to the DOJ a “service dog” has been “individually trained to do work or perform tasks for an individual with a disability and the tasks performed by the dog must be directly related to the person’s disability.” 1 A disability is defined as a “physical or mental impairment that substantially limits one or more major life activities of such individual; a record of impairment; or being regarded as having such an impairment.” 2 Service dog access is well litigated but what about dogs used for emotional support?

The Fair Housing Act requires reasonable accommodations for people with disabilities to enjoy equal use and enjoyment of a home. The DOJ settled a lawsuit against Kent State University over a student who was refused on campus housing for an emotional support animal prescribed by a physician for anxiety. 3 The student identified the disability and the need for an emotional support animal but refused to disclose whether the animal was trained. The DOJ explained the need for this expansion of privilege to untrained animals ensures individuals with disabilities have the accommodations they need to perform daily life functions.

Missouri laws provide accommodation for guide, hearing, medical alert, mobility, search and rescue, and professional therapy dogs, but not for mental health assistance dogs. State discrimination protections also only extend to visual, aural, and physical disability dogs. The same can be said about housing accommodations. The Missouri House passed a bill in 2016 to add protections for mental health service dogs in Missouri.
Legal protections vary because of the wide range of uses service dogs have. Visual and aural impairment are obvious examples. Diabetics find comfort from animals trained to alert to episodes of high or low blood sugar. 4 Epileptic service dogs alert if a person is having a seizure, activate alarm systems, and carry essential medical information for first responders. 5 Great Danes and larger breeds can be trained to lean against people with balance disorders which can be especially helpful for veterans with vertigo from blast injuries. 6 Physical assistance dogs are able to open doors, pick up items, and retrieve for people with missing limbs or ambulatory disorders. 7

Mental health service animals treat a variety of disabilities like depression, post-traumatic stress disorder, bipolar disorder, schizophrenia, and autism. Dogs can be taught calming techniques, to remind a patient to take medication, and wake a person from PTSD related nightmares. The American Psychological Association studied the impact of service dogs on posttraumatic stress disorder and found anecdotal evidence supporting human-animal interaction as a viable treatment method. However, the Department of Veterans Affairs (VA) does not support the use of service animals for PTSD. 8

The VA’s position illustrates the division over funding that prevents service dog industry growth. Currently the VA will provide funding for service dogs used to treat physical disabilities, but not mental health conditions, citing a lack of scientific research. Critics have labeled this practice as discriminatory. Congress compelled the VA to perform the necessary research with the Franken-Isakson Service Dogs for Veterans Act of 2010. However, in 2012 that study was ended prematurely due to animal neglect. 9 The VA’s resistance to research and funding illustrates the challenges the service dog industry faces.

Lack of funding is the primary obstacle to use of service dogs because the financial burden falls on the disabled person. The high-end retailers of service dogs can charge upwards of $20,000 just to purchase a dog. 10 Some organizations provide the dog for free but lifetime maintenance is another $20,000 and there are 1,600 people on the wait list. 11 Organizations, like Kansas City’s own Battle Buddy Service Dogs, help disabled people train dogs themselves, but they still rely on donations. To avoid waiting for years and paying thousands of dollars some people successfully train their own service dogs. The DOJ regulations regarding a service dog do not mandate any specific training program.

Minimal regulation has led to fake service dogs, where people who fraudulently assert an animal is a “service dog” to get some benefit. Because of this lack of regulation, business owners and employees can refuse service and expel a service dog if it isn’t housebroken, or fails to behave itself. It is a class C misdemeanor in Missouri to impersonate a person with a disability to receive service dog protection for an animal. Colorado is the latest to join a growing number of states cracking down on fraudulent service dog use. 12 Telling the legal difference rests on whether the person has a disability, and whether the dog is under their control.

Traditional well trained aural, visual, physical and psychological impairment service dogs have rights that are well litigated. Further litigation will determine the extent of rights for dogs with less training, owner liability, and whether medical insurance should be picking up the tab for their maintenance.